The invention herein is directed to a pharmaceutical tablet which comprises both an NSAID and misoprostol.
Nonsteroidal anti-inflammatory drugs (NSAIDs) comprise a class of drugs which have therapeutic value especially for the treatment of inflammatory conditions such as exhibited in inflammatory diseases like osteoarthritis and rheumatoid arthritis. While the NSAIDs present a beneficial therapeutic value, they also exhibit an undesirable ulcerogenic effect generally associated with chronic use. NSAID induced ulcers in the stomach can be dangerous. Such ulcers generally exhibit few or no symptoms and may cause bleeding when undetected. In some instances, bleeding ulcers can prove fatal.
Certain prostaglandins have been shown to prevent NSAID induced ulcers. Misoprostol is a prostaglandin which has been accepted for use in the treatment of NSAID induced ulcers in many countries, including the United States.
It is desirable to provide a pharmaceutical composition which exhibits the beneficial properties of an NSAID and which also exhibits the beneficial properties of misoprostol for countering the ulcerogenic side effects attendant to NSAID administration.
This can be achieved by combining an NSAID and misoprostol in a single pharmaceutical tablet. However, this is not easy to do, because misoprostol is highly unstable, and it is thus desirable not to have the misoprostol and NSAID mixed together, so as to prevent any deleterious effect of the NSAID on the stability of the misoprostol.
One solution to this problem, which is disclosed in U.S. Pat. No. 5,601,843, is to produce a composition in the form of a tablet comprising within it a smaller tablet. Such a composition is known in the art as a xe2x80x9ccompression coatedxe2x80x9d tablet or xe2x80x9cmantlexe2x80x9d tablet. The portion of the larger tablet (i.e. the whole composition) that surrounds the smaller inner or xe2x80x9ccorexe2x80x9d tablet is known as the xe2x80x9cmantlexe2x80x9d. In the compositions of U.S. Pat. No. 5,601,843, the misoprostol and NSAID are separated from each other by having the core tablet comprise the NSAID and the mantle comprise the misoprostol.
It is also disclosed that, in order to prevent contact between the misoprostol and the NSAID at the surface of the inner core, the inner core may be coated with an inert film coating. Such coating may be an enteric film coating, which also serves to reduce the likelihood of the NSAID dissolving in the stomach and thereby prevent exposing the stomach to the NSAID.
While the invention of U.S. Pat. No. 5,601,843 accomplishes its objective of separating the NSAID from the misoprostol, it has certain disadvantages.
One disadvantage is that the process of making the mantle tablet is complicated, and the machinery needed is specialized and relatively expensive. In the process of manufacture of the mantle tablet, it is necessary to first make the smaller core tablet, which is done on a conventional tablet press, and then to use a compression coating press to make the final tablet. Such a press makes the final tablet much the same as a conventional tablet is made, but must have the added feature of being able to insert the core tablet along with the mantle powder mix into each die for compression into the final tablet.
Another disadvantage is that the final tablet must be substantially larger than the inner core tablet to have an adequate quantity of compressible mantle material completely surrounding the inner core. In the compositions of U.S. Pat. No. 5,601,843, the substantial mass of the mantle is in any event necessary to comprise the misoprostol. This is because misoprostol is unstable in pure form, and the only way known in the art to stabilize misoprostol is to process it into a dispersion comprising 1 part misoprostol in from about 50 to about 500 parts of a polymer, as disclosed in U.S. Pat. No. 4,301,146. The examples of U.S. Pat. No. 5,601,843 all use a dispersion of 1 part misoprostol in 100 parts hydroxypropyl methylcellulose (xe2x80x9cHPMCxe2x80x9d). Also this dispersion must be mixed with a binder, lubricant and other ingredients to make a mixture which can be compressed into the mantle. Thus it follows that the mass of the mantle must be large relative to the core.
In all nine examples of U.S. Pat. No. 5,601,843, the core tablet has a mass of 90 mg and the mantle has a mass of 265 mg. The nine examples differ from each other only in details of film coatings applied to the core tablet before it is inserted into the final tablet. Hence, in all nine examples, the total mass of the final tablet is at least 355 mg, despite the fact that the mass of the core tablet is only 90 mg.
The object of the present invention is to enable a pharmaceutical tablet that incorporates both an NSAID and misoprostol, but overcomes these disadvantages.
The present invention is a pharmaceutical composition in the form of a tablet comprising a core and a film coating applied over the core, wherein the core comprises an NSAID and the film coating comprises misoprostol.
As aforesaid, the misoprostol must be stabilized by processing it into a dispersion in a polymer. However, a film coating also must comprise a polymer. The essence of the invention is to film-coat the core tablet with a coating comprised of both the misoprostol and a polymer, so that the polymer simultaneously serves the two purposes of stabilizing the misoprostol and forming a polymeric film coating around the core.
The procedure of applying the film coating comprising misoprostol is to dissolve the misoprostol and polymer in solvent, optionally along with other ingredients such as plasticizers and surfactants, and to spray the solution onto the tablets in conventional tablet coating equipment. As the solvent is evaporated, the film coating comprising the misoprostol and polymer is formed around the tablet.
The NSAID contained within the core tablet will preferably be piroxicam, or diclofenac, or a salt of diclofenac, such as diclofenac sodium or diclofenac potassium. Most preferably, the NSAID will be diclofenac sodium.
Where diclofenac or a salt thereof is used, the amount per tablet will preferably be from about 25 to about 75 mg. The core tablet containing diclofenac or salt thereof will contain, along with the diclofenac or salt thereof, usual tablet excipients such as binders, lubricants, fillers and the like. Preferably, the tablet containing the diclofenac or salt thereof will be coated with an enteric film coating to prevent the diclofenac or salt thereof from dissolving until after it has passed through the stomach and entered the small intestine. The enteric coating can be formulated with any suitable enteric coating polymer, many of which are known to those skilled in the art.
Where piroxicam is used as the NSAID, the amount per tablet will preferably be from about 10 to about 20 mg. Again, the tablet containing piroxicam will also comprise usual tablet excipients.
It will be understood that the film coating comprising misoprostol may be sprayed directly on the core tablet containing the NSAID. Optionally, the core tablet may first be coated with an enteric film coating, and the film coating comprising the misoprostol applied as an overcoat.
Also optionally, the core tablet may first be coated with an enteric film coating and then overcoated with another inert film coating, and then overcoated again with the film coating comprising misoprostol.
Also optionally, another inert film coating may be applied on top of the film coating which comprises the misoprostol, in order to protect the misoprostol from the effects of light and air.
The polymer used in the film coating which comprises the misoprostol may be any water-soluble polymer which will form a film coating when sprayed onto a tablet and which will also stabilize misoprostol. The polymer will preferably be selected from povidone and water-soluble cellulose derivatives, and most preferably will be hydroxypropyl methylcellulose. The ratio of polymer to misoprostol by weight will preferably be from about 10 to about 100 parts polymer to 1 part misoprostol, and more preferably from about 15 to about 50 parts polymer to 1 part misoprostol.
The solvent system used to dissolve the misoprostol and polymer may be comprised of water or organic solvents and will preferably be a mixture of a chlorinated hydrocarbon and an alcohol, and most preferably be a mixture of methylene chloride and an alcohol. The solution will optionally also comprise other ingredients, such as a plasticizer or surfactant.